The Dissociative Factor in Symptom Reports of Rheumatic Patients with and Without Fibromyalgia

The main objective of this study was to investigate the prevalence of dissociation and its relationships to symptom reporting in fibromyalgia (FM) and other rheumatic disorders (non-FM). The participants were 73 women with FM and 85 relatively matched women with other rheumatic disorders. The participants were administered the Dissociative Experiences Scale (DES), the Profile Of Mood States (POMS), and a 50-item medical checklist. The prevalence of dissociation (DES q 25) was significantly higher in FM patients(30.1%) compared to other rheumatic disorders (7.0%). Symptom reporting correlated with measures of dissociation in both patient groups (FM:R = 0.42, p < .001; non-FM:R = 0.44, p < .001), when controlled for age, depression, and anxiety. A regression analysis confirmed the strong linkage between somatic variation and dissociation. The results suggest that dissociation is a problem for a substantial segment of patients with fibromyalgia and that dissociation is related to certain physical symptoms of fibromyalgia. Dissociation offers a different perspective on medically unexplained symptoms and may need to be addressed in future research.     

Toward a New Concept of Global Morality

The human community faces today the most serious challenges ever to have confronted the planet in the areas of health, environment, and security. Science and technology are essential for responding to these challenges. More is needed, however, because science is not equipped to deal adequately with the values dimensions and the political issues that accompany the challenges. For an adequate response, there must be cooperative effort by scientists and statespersons, informed for moral leadership by the religious wisdom that is available. The religious communities can provide this spiritual dimension, thereby fulfilling their traditional role, but it will require their coming to terms with the character of the scientific and technological base of contemporary culture. The paper lays the conceptual groundwork for understanding these issues.     

Elemental and Configural Processes in Patterning Discrimination Learning

Three experiments used appetitive conditioning with rats to examine the involvement of elemental and configural processes in positive and negative patterning discriminations. The first experiment demonstrated that negative and, to some extent, positive patterning discriminations were learned more rapidly when these discriminations consisted of stimulus elements that had previously been the reinforced as opposed to the non-reinforced elements of a simple discrimination. Experiment 2 revealed an excitatory summation effect during the early phase of negative patterning learning that depended upon discrimination pretraining. The final experiment demonstrated faster discrimination learning between the compound and the less salient, rather than the more salient, element of an instrumental patterning task. The present set of results were interpreted as reflecting the possibility, consistent with connectionist theory, that internal representations of the conditioned stimuli change over the course of a patterning discrimination.     

Practical Implementation Science: Developing and Piloting the Quality Implementation Tool

According to the Interactive Systems Framework for Dissemination and Implementation, implementation is a major mechanism and concern in bridging research and practice. The growing number of implementation frameworks need to be synthesized and translated so that the science and practice of quality implementation can be furthered. In this article, we: (1) use the synthesis of frameworks developed by Meyers et al. (Am J Commun Psychol, 2012) and translate the results into a practical implementation science tool to use for improving quality of implementation (i.e., the Quality Implementation Tool; QIT), and (2) present some of the benefits and limitations of the tool by describing how the QIT was implemented in two different pilot projects. We discuss how the QIT can be used to guide collaborative planning, monitoring, and evaluation of how an innovation is implemented.     

Using a Training-of-Trainers Approach and Proactive Technical Assistance to Bring Evidence Based Programs to Scale: An Operationalization of the Interactive Systems Framework’s Support System

Bringing evidence based programs to scale was a major initial impetus for the development of the Interactive Systems Framework for Dissemination and Implementation (ISF). The ISF demonstrates the importance of the Support System in facilitating the uptake of innovations in the community (the Delivery System). Two strategies that members of the Support System commonly use are training‐of‐trainers (TOT) models and technical assistance (TA). In this article, we focus on the role of the Support System in bringing evidence‐based programs (EBPs) to scale in the Delivery System using a case example, with special attention on two strategies employed by Support Systems—training‐of‐trainers (TOT) and proactive technical assistance. We then report on findings from a case example from the Promoting Science Based Approaches to Teen Pregnancy Prevention project that furthers our conceptualization of these strategies and the evidence base for them. We also report on the limitations in the literature regarding research on TOTs and proactive TA and provide suggestions for future research on TOTs and proactive TA that will enhance the science and practice of support in the ISF. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

Development of the Mental Clutter Scale

Mental fog is a core symptom of fibromyalgia. Its definition and measurement are central to an understanding of fibromyalgia-related cognitive disability. The Mental Clutter Scale was designed to measure mental fogginess. In an exploratory factor analysis of two different samples (n=128 and n=170), cognitive symptoms of fibromyalgia loaded on 2 dimensions: cognition and mental clarity. The mental clarity factor comprised 8 items with factor loadings greater than .60 and was named the Mental Clutter Scale. The factor stability of the new scale was good, internal consistency was .95, and test-retest reliability over a median of 5 days was .92. The 8-item scale is a quick measure of mental fog that provides clinicians with information about cognitive functioning in fibromyalgia.     

Childhood Social Withdrawal,Interpersonal Impairment,and Young Adult Depression: A Mediational Model

Building on interpersonal theories of depression, the current study sought to explore whether early childhood social withdrawal serves as a risk factor for depressive symptoms and diagnoses in young adulthood. The researchers hypothesized that social impairment at age 15 would mediate the association between social withdrawal at age 5 and depression by age 20. This mediational model was tested in a community sample of 702 Australian youth followed from mother’s pregnancy to youth age 20. Structural equation modeling analyses found support for a model in which childhood social withdrawal predicted adolescent social impairment, which, in turn, predicted depression in young adulthood. Additionally, gender was found to moderate the relationship between adolescent social impairment and depression in early adulthood, with females exhibiting a stronger association between social functioning and depression at the symptom and diagnostic level. This study illuminates one potential pathway from early developing social difficulties to later depressive symptoms and disorders.     

Comparing Holographic Reprocessing and Prolonged Exposure for Women Veterans with Sexual Trauma: A Pilot Randomized Trial

This pilot study compares an emerging evidence-based treatment, holographic reprocessing (HR) to prolonged exposure (PE) versus a person-centered (PC) control group to treat symptoms of distress in female Veterans with sexual trauma. In contrast to PE, HR does not include exposure to a target event of trauma. Instead, HR focuses on healing the internal working model or type of attachment style that may form as a result of interpersonal trauma or maltreatment. The model reveals how people perceive themselves and others. These perceptions set in motion emotional, cognitive, and behavioral tendencies wherein people unconsciously replicate similar types of relationships that reinforce their worldview. Fifty-one female Veterans with sexual trauma were randomly assigned to one of three treatments and completed pre- and post-treatment measures of psychiatric symptoms (anxiety, depression, and PTSD) and post-traumatic cognitions. ANOVAs found significant decreases on all variables. Post-hoc comparisons revealed that HR and PE treatments demonstrated significantly greater decreases in symptoms compared to the PC control group. Chi square analyses revealed that HR produced a significantly lower dropout rate 1 (6 %) compared to PE 7 (41 %) and PC 6 (35 %). These initial results are promising and further investigation of HR is warranted.